MIKADO Academy of Music Registration Form
An annual, one time registration fee of $25 is due at registration.
Select a Semester *
Student's First Name *
Your answer
Student's Last Name *
Your answer
Gender *
Parent/Guardian Name *
Your answer
Email *
Your answer
Street Address *
Your answer
City/State/Zip *
Your answer
Cell Phone *
Your answer
Student's School *
Your answer
Student's Grade *
Church Name
If you attend a church, please give the name of the church below.
Your answer
Area of Study *
Lesson Length Requested *
(Note: Some instructors advise or require longer lesson times for more advanced students. Your designated instructor will contact you if applicable.)
How many years have you previously studied your instrument? *
In this section you may indicate any former studios or instructors you worked with, optionally provide any desired days and times of study (we will try to accommodate you the best we can), and teacher requests.
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service